Toxic effects

Overdose with gabapentin is not likely to be life-threatening, due to saturation of the amino acid transporters, which results in most of the drug being unabsorbed and excreted in the faeces.

The effects of gabapentin on human pregnancy and breast-fed infants are unknown. Indications and contraindications

Several placebo-controlled trials confirm gabapentin's efficacy as adjunctive therapy in some patients with partial seizures, especially complex partial seizures and partial seizures with secondary generalization. (29> Case reports suggest it may be useful in the treatment of neuropathic pain.(31) Case reports and open, uncontrolled studies of gabapentin also suggest efficacy in treating bipolar disorder, major depression, panic disorder, and social phobia. (32) However, controlled studies are lacking.

Gabapentin is contraindicated in patients with known hypersensitivity to the drug. Interactions

Gabapentin is not metabolized by the liver and is not protein bound. Therefore, it has no pharmacokinetic effects on other antiepileptic drugs or contraceptive pills. Antacids containing aluminium and magnesium hydroxide may decrease gabapentin absorption from the gut and cimetidine may reduce its renal clearance, but neither of these interactions is thought to be clinically significant. (29)

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